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General NPI Number Information
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NPI Number | 1720506694
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Entity Type | Organization
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Legal Business Name | J P COOK DC, PC
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Dates
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Enumeration Date | 08/31/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 404 S JEFFERSON ST
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City | KEARNEY
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State | MO
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Zip | 64060-8815
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Country | US
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Telephone | 816-635-2645
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Fax | 816-635-2845
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Provider Business Mailing Address
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Address Line | 404 S JEFFERSON ST
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City | KEARNEY
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State | MO
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Zip | 64060-8815
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Country | US
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Telephone | 816-635-2645
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Fax | 816-635-2845
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Authorized Official
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Title or Position | OWNER
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Name | DR. JUSTIN PAUL COOK
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Credential | DC
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Telephone | 816-635-2645
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 2016013887
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License Number State | MO
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